Subdural Empyema

History:

18 year old female with 2 month history of seizures. Fever and headache for the last two weeks.

Click to enlarge
Click to enlarge
Click to enlarge
Click to enlarge
Click to enlarge
Click to enlarge

Findings:

An enhancing subdural fluid collection is noted over the right frontal convexity with considerable vasogenic edema and mass effect seen on the T2-weighted and FLAIR images.

Differential:

  • Subdural Embyema
  • Epidural abscess
  • Intracerebral abscess
  • Necrotic (agressive)malignancy, e.g., GBM (unlikely)

Discussion:

Salmonella is unusual in an immuno-competent patient as this patient was. There was a history of chronic otitis media though no acute otitis was found on admission.
September 16, 2003 Back to teaching file index